New Therapies for Inflammatory Bowel Diseases Show Strong Long-Term Acceptance

Inflammatory bowel diseases (IBD) such as Crohn's disease, ulcerative colitis, and collagenous colitis are chronic conditions marked by persistent inflammation of the digestive tract. These diseases can affect the entire gastrointestinal system or specific sections, with Crohn's disease and ulcerative colitis being the most prevalent forms. Managing IBD typically involves reducing or suppressing inflammation to achieve and maintain periods of remission, in which patients experience minimal or no symptoms.

During acute flare-ups, anti-inflammatory medications, including mesalazine--sometimes in combination with glucocorticoids--are frequently administered to control symptoms. For long-term disease control and prevention of relapses, continuous therapy is necessary. Established medications such as mesalazine, prednisolone, azathioprine, and methotrexate have traditionally been used for maintenance therapy. In recent years, new immunomodulatory treatments have become available, expanding the options for patients and healthcare providers.

These newer therapies include tumor necrosis factor-alpha (TNF-?) inhibitors such as adalimumab and infliximab, integrin antagonists like vedolizumab, interleukin (IL)-12/23 and IL-23 inhibitors including ustekinumab, risankizumab, and mirikizumab, as well as Janus kinase (JAK) inhibitors such as upadacitinib, tofacitinib, and filgotinib. These treatments target specific immune pathways involved in the inflammatory process, offering alternative mechanisms of action compared to traditional drugs.

One of the main challenges in IBD management is ensuring patients adhere to their prescribed long-term therapies--especially when symptoms are well controlled. Adherence, or therapy persistence, is considered an important indicator of both the safety and effectiveness of a given treatment over time. To evaluate how well patients maintain these newer therapies, a research team from the German Competence Network for Digestive Diseases conducted a comprehensive analysis using data from the TARGET registry. This registry collects information on the efficacy and safety of IBD treatments across Germany.

The study included 813 patients who had received at least one of several modern immunomodulatory treatments, including adalimumab, infliximab, vedolizumab, IL-12/23 or IL-23 inhibitors, and JAK inhibitors. The analysis focused on therapy persistence rates over a five-year period.

The findings, presented at the Visceral Medicine 2025 Congress in Leipzig, revealed that patients generally demonstrate high long-term persistence with these advanced IBD therapies. Over the five-year observation period, immunomodulators maintained persistence rates between 70 and 80 percent. Specifically, 77.1 percent of patients continued adalimumab therapy after five years, while persistence for infliximab was 80 percent. Vedolizumab therapy was maintained by 72.3 percent of patients. For IL-12/23 and IL-23 inhibitors, the persistence rate reached 79.5 percent, and for JAK inhibitors, an impressive 93.9 percent was observed. No statistically significant differences were found between these therapy groups.

The high persistence rates suggest that patients generally tolerate and accept these newer immunomodulatory treatments, supporting their use as effective long-term options for managing IBD. Continued monitoring of treatment outcomes and safety is essential as more patients transition to these advanced therapies. The study's results provide valuable insights for clinicians aiming to optimize long-term disease management strategies and improve the quality of life for individuals living with chronic inflammatory bowel diseases.